A Pap smear, also known as a Pap test, is a screening test usually done alongside a pelvic exam. A Pap test looks for any abnormal or precancerous cell changes in the cells on the cervix — the canal between the vagina and uterus.
If the Pap test results show these cell changes, this is usually called cervical dysplasia.
Cervical dysplasia is a condition of abnormal cellular growth on the cervix.
Abnormal Pap test results do not mean you have cancer or will have cancer in the future. Most women with abnormal Pap smears never develop cancer, but some may have very treatable pre-cancer.
Low-grade cell changes tend to go back to normal on their own. However, high-grade changes can develop into cancer if the cells aren’t removed.
What causes cervical dysplasia?
Dysplasia is usually caused by the human Papillomavirus (HPV). HPV is a common sexually transmitted virus that can be passed from person to person during vaginal, anal, and oral sex. Both women and men can be infected with HPV.
Because HPV is typically asymptomatic, many people may be infected with the virus without realizing it. In fact, most sexually active people will get it at least once in their lives, but won’t know because their immune systems clear it before it becomes a problem. However, in cases where the immune system can’t get rid of it, HPV will cause mild to severe dysplasia in the cervix.
Just because you have cervical dysplasia, it does not mean you will get cervical cancer. However, Dr. Aliabadi will want to closely monitor your cervix more frequently – and possibly conduct treatment – to prevent further cell changes that may become cancerous.
I have abnormal Pap smear results. Now what?
An abnormal Pap smear is a red flag that a patient has cervical dysplasia, and further evaluation is recommended to determine the appropriate diagnosis and treatment. Further testing includes cervical cancer screening tests such as:
Colposcopy. First, vinegar or acetic acid is used to stain the cells of the cervix and vagina. The doctor then uses a colposcope to magnify the appearance of the cervix and see where the abnormal tissue is. Depending on the size and number of the abnormal cells, Dr. Aliabadi may take a tissue sample for further testing.
HPV test. There are two strains of HPV that are specifically high risk for cervical cancer: HPV 16 and 18. A biopsy of the abnormal cells allows Dr. Aliabadi to test for these specific strains of HPV.
Endocervical curettage. Using a spoon-shaped tool called a curette, our doctor scrapes the cervix to collect a thin layer of cervical cells.
Cone biopsy. A cone biopsy removes a cone-shaped wedge of abnormal cells. It takes more tissue than a regular cervical biopsy, providing more test material.
Risk factors for cervical dysplasia
Most cervical dysplasia is caused by HPV, so anything that increases your risk of HPV exposure or weakens your immune system will increase your risk. Some things that increase your cervical dysplasia risk include:
Weakened immune system. Any condition that suppresses or weakens the immune system increases the risk that an HPV infection will result in cervical dysplasia.
Immunosuppression medication. Patients who’ve recently undergone an organ transplant or who have an autoimmune disease may be treated with immunosuppression medication, which weakens the immune system.
Smoking depresses antibodies and weakens the immune system. Smokers are two times more likely to develop a severe case of dysplasia than non-smokers.
Unsafe sexual practices. Having multiple sexual partners or not using condoms increases your risk of HPV exposure.
The American Cancer Society recommends that women begin regular cervical cancer screening at age 21.
A vaccine to prevent cervical dysplasia and cervical cancer
One important step in significantly reducing your chances of dysplasia and cervical cancer is to get the HPV vaccine. Two drugs have been approved by the FDA: Gardasil and Cervarix. They have been found to prevent the most dangerous strains of HPV, including the strains that are known to cause cervical cancer and genital warts.
The Centers for Disease Control advises that girls get vaccinated well before they are sexually active – at age 11 or 12. It is strongly recommended because it is currently the safest and most effective method to prevent cervical cancer. Girls and young women over the age of 12 should get vaccinated as well, even if they are already sexually active.
It is also recommended that men get vaccinated against HPV.
What is cervical dysplasia treatment?
Dr. Aliabadi will make sure you understand the many options available for treating dysplasia. Your treatment plan will depend on your age and the severity of your case. In mild cases, especially in older women, you may only need monitoring with repeat Pap smears every few months.
Possible treatments for dysplasia include:
Cone biopsy can be used to both examine and remove the portion of abnormal cervical tissue growth.
Each of these treatments carries a risk of bleeding and may increase the risk of complications during pregnancy. Women who plan on carrying children in the future should talk to their doctor about their concerns.
After treatment, our gynecologist will likely recommend follow-up Pap smears every few months to make sure all of the abnormal cells have been removed. After a few consecutive normal tests, you may return to an annual regular Pap smear schedule.
Hysterectomy is often used in cases where the area of abnormal growth was found in the glandular tissue of the cervix or if severely abnormal cells were not completely removed by other treatments. With a total hysterectomy — removal of the uterus and cervix — you will no longer be at risk of cervical cancer.
Have questions about your health? Talk to Dr. Aliabadi
Dr. Aliabadi and her compassionate team are experts in women’s health care. When treated by Dr. Aliabadi, you’re guaranteed to feel safe, heard, and well cared for.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center is conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
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Abnormal Pap test FAQs
Can there be a false abnormal Pap smear?
It is possible to have a false abnormal if vaginal cream, gels, medicines, or douches have been used within 48 hours of a screening test, or if you had sex, or are menstruating. Yeast infections can also affect the results of a Pap test, sometimes causing a false or unclear result.
What are LSIL and HSIL?
LSIL (Low-grade Squamous Intraepithelial Lesion) and HSIL (High-grade Squamous Intraepithelial Lesion) are terms used to describe abnormal changes in the cells on the surface of the cervix.
LSIL indicates mild abnormalities, often associated with human Papillomavirus (HPV) infection. These low-grade changes are usually not immediately dangerous and might resolve on their own without treatment, though they do require monitoring to ensure they do not progress.
HSIL, on the other hand, suggests more significant abnormalities that are more likely to lead to cervical cancer if left untreated. HSIL is considered serious and usually requires further diagnostic testing.
What are other causes of an abnormal Pap test?
While atypical squamous cells of undetermined significance (ASC-US) are the most common abnormal Pap test findings, this result just means some cells don’t look completely normal. It’s not clear if the changes are caused by HPV infection.
A sexually transmitted infection, such as herpes or trichomoniasis, inflammation in the pelvic area, or changes in hormones that occur during pregnancy or menopause can also cause cells to look abnormal.
Other common terms used to describe abnormal Pap results include:
Abnormal cell changes
Precancerous cells changes
CIN (cervical intraepithelial neoplasia)
SIL (squamous intraepithelial lesions) low to high-grade
All of these terms mean the same thing — abnormalities were found.
How is a Pap test performed?
How is a Pap test performed?
The patient lies on an exam table and a speculum is inserted into the vagina to widen it, allowing your OB-GYN to access and view the cervix. Using a small brush or spatula, the provider gently scrapes a sample of cells from the cervix. This sample is then sent to a laboratory for analysis to check for abnormalities that could indicate conditions like cervical cancer or precancerous changes.
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Frequently Asked Questions
How often do ovarian issues impact Pap results?
Ovarian issues do not directly impact Pap results. Pap smears primarily detect cervical cell abnormalities, not ovarian issues. However, conditions like ovarian cysts may sometimes lead to abnormal cells in the cervix, affecting Pap results indirectly. Regular screening helps monitor overall gynecological health.
Can cystic growths influence cervical screening outcomes?
Cystic growths in the cervix can make it challenging to obtain clear Pap smear results. They can obscure the view of the cervix, potentially affecting the accuracy of the screening test. This can lead to false abnormal results or the need for additional testing to confirm the findings.
What Pap result anomalies can cysts provoke?
Cysts can cause anomalies in Pap results, which may include false abnormalities, misleading test outcomes, or the need for additional testing and monitoring to ensure accurate diagnosis and appropriate treatment. Close monitoring by a healthcare provider is crucial in such cases.
Are Pap anomalies indicative of ovarian pathology?
Pap anomalies are primarily indicative of cervical pathology rather than ovarian issues. Ovarian pathology is usually detected through separate diagnostic procedures like ultrasounds, blood tests, or imaging studies specific to the ovaries. Pap smears are focused on assessing cervical health and detecting abnormalities that may lead to cervical cancer.
How do ovarian changes affect cervical health?
Ovarian changes do not typically directly affect cervical health. However, changes in hormones can impact cervical cells, potentially affecting Pap test results. It's important to monitor any abnormalities with Dr. Aliabadi for proper management and treatment if necessary.
Can cyst presence alter HPV detection rates?
The presence of cysts does not alter HPV detection rates. Cysts are fluid-filled sacs that are separate from the cervical cells where HPV is detected during a Pap smear. HPV detection is not impacted by the presence of cysts in the cervix.
Are certain ovarian conditions linked to Pap changes?
Certain ovarian conditions can be linked to Pap changes. For instance, ovarian cysts, polycystic ovary syndrome (PCOS), and hormonal imbalances can impact cervical cell changes detected in a Pap smear, causing abnormalities that may warrant further investigation or monitoring by a healthcare provider. It is essential to discuss any concerning links between ovarian conditions and Pap changes with a medical professional for appropriate management and follow-up.
What hormonal fluctuations impact Pap test accuracy?
Hormonal fluctuations, such as those during pregnancy or menopause, can impact Pap test accuracy by causing abnormalities in cervical cells. It's crucial to discuss any hormonal changes with your doctor to ensure correct interpretation of your results and appropriate follow-up care.
Does ovarian health affect cervical cancer detection?
Changes in ovarian health can impact cervical cancer detection due to hormonal fluctuations and potential effects on the reproductive system. Regular screenings are crucial to monitor cervical health regardless of ovarian health status. Consulting your healthcare provider for personalized guidance is recommended.
What infections besides HPV alter Pap findings?
Sexually transmitted infections like herpes or trichomoniasis, pelvic inflammation, or hormonal changes during pregnancy or menopause can also cause abnormal Pap findings.
Can benign ovarian cysts mimic malignancy on Paps?
Benign ovarian cysts do not mimic malignancy on Paps. Pap smears primarily screen for cervical abnormalities, not ovarian issues. Ovarian cysts are typically evaluated through imaging tests like ultrasounds, CT scans, or MRI scans, and may require further evaluation by a gynecologist or healthcare provider.
Are Pap inconsistencies ever linked to cysts?
Pap inconsistencies are not typically linked to cysts. Abnormal Pap smears may be due to HPV, infections, or cervical dysplasia - not related to cysts. Consult with Dr. Aliabadi for any concerns about Pap results.
How do cervical polyps impact Pap smear clarity?
Cervical polyps can impact Pap smear clarity by potentially obscuring the view of the cervical cells during the test, leading to difficulty in obtaining accurate results. This can sometimes necessitate further evaluation or repeat testing to ensure the cells are properly evaluated for abnormalities.
Do inflammation markers on Paps suggest cysts?
Inflammation markers on Pap smears typically do not suggest cysts. These markers can be indicative of various conditions, such as infections or other abnormalities in the cervix, which would require further evaluation by a healthcare provider.
Can cyst-related bleeding affect Pap interpretations?
Cyst-related bleeding can affect Pap interpretations by potentially obscuring the visibility of abnormal cells during the test, leading to potential misinterpretations or false results. It is essential to provide this information to your healthcare provider when discussing your Pap smear results for accurate assessment and management.
What immune factors can skew Pap results?
Factors such as vaginal creams, gels, medicines, douches, sex, or menstruation within 48 hours can skew Pap test results if present. Additionally, sexually transmitted infections or hormonal changes can affect cell appearance. Immune system variations play a role too.
Do endometriosis-related cysts affect Pap outcomes?
Endometriosis-related cysts do not directly affect Pap smear outcomes. However, the presence of endometriosis can make it more challenging to interpret Pap results accurately. It's essential to notify your healthcare provider about endometriosis history to ensure proper evaluation of Pap test results.
Could cyst removal procedures obscure Pap readings?
Yes, cyst removal procedures may cause temporary changes in Pap readings. It is essential to inform your healthcare provider about any recent procedures to ensure accurate interpretation of Pap test results. Communication is key for clear and precise medical assessment.
How might ovarian treatments alter Pap follow-ups?
Ovarian treatments can impact Pap follow-ups by potentially affecting the hormonal balance and cell health in the cervix. This may lead to changes in Pap test results, necessitating closer monitoring or more frequent screenings to ensure any abnormalities are promptly addressed.
Can non-HPV viruses cause Pap test irregularities?
Yes, non-HPV viruses like herpes or trichomoniasis, inflammation in the pelvic area, or hormonal changes in pregnancy or menopause can cause abnormal Pap test results. These infections may lead to cells appearing abnormal but can be managed with proper monitoring and treatment.
Are Pap smear abnormalities always pathology signs?
Yes, Pap smear abnormalities can indicate pathology, ranging from mild changes due to HPV to more severe abnormalities that may lead to cancer if untreated. Regular monitoring and possibly treatment are essential to prevent progression to a dangerous condition.
Could ovarian surgery history affect Pap accuracy?
Previous ovarian surgery history may impact Pap accuracy due to potential scarring or changes in the cervix. Discuss any concerns about your medical history with your healthcare provider for personalized guidance. It's essential to keep your provider informed to ensure accurate screenings.
What Pap smear alterations indicate ovarian issues?
Pap smear alterations may indicate ovarian issues when detecting abnormal cells that could suggest an underlying problem. Abnormal results from a Pap smear may prompt further investigation by a healthcare provider to rule out or address any potential ovarian issues.
How do systemic illnesses affect Pap diagnoses?
Systemic illnesses can affect Pap diagnoses by potentially causing abnormal cell changes in the cervix. Conditions like diabetes, HIV, or autoimmune diseases can impact the immune system's ability to clear infections like HPV, leading to more severe dysplasia or cervical changes that may warrant closer monitoring and treatment.
Can Pap smears detect ovarian-related dysplasia?
Pap smears are specifically designed to screen for cervical cell abnormalities. While ovarian cancer can sometimes spread to the cervix, Pap smears focus on cervical health and are not intended for detecting ovarian-related dysplasia. Additional tests are typically needed for ovarian health assessments.
How reliable are Pap smear results for cysts?
Pap smears are primarily done to screen for cervical abnormalities and are not typically used to detect or diagnose cysts. For evaluating cysts, imaging tests like ultrasounds or MRIs are more reliable. Consult with your healthcare provider for proper diagnosis and management of cysts.
What cervix conditions may cysts aggravate on Paps?
Cysts on Paps may worsen cervical conditions like high-grade changes and cervical dysplasia, potentially leading to cancer. These abnormal cells require close monitoring, possible treatment, and regular follow-ups by Dr. Aliabadi to prevent progression to more severe stages.
Could ovarian dysfunction lead to repetitive Pap anomalies?
Ovarian dysfunction may not directly lead to repetitive Pap anomalies. However, underlying hormonal imbalances can impact cervical cell changes, possibly affecting Pap smear results. Close monitoring and treatment by a healthcare provider like Dr. Aliabadi are crucial for accurate assessment and management.
Do medications for ovarian issues alter Pap findings?
Medications for ovarian issues can sometimes influence Pap test results. It's important to discuss any medications you are taking with your healthcare provider to understand how they might impact your Pap findings. Regular communication with your provider is key to ensure accurate interpretation of test results and appropriate follow-up care.
How do Pap smear patterns reflect ovarian health?
Pap smear patterns are specific to cervical health, not directly reflecting ovarian health. The test screens for abnormal cervical cells, often linked to Human Papillomavirus (HPV) infection and cervical dysplasia. Abnormalities suggest the need for monitoring to prevent cervical cancer, not ovarian issues.
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